Cases Report: Experience with Rheolytic Thrombectomy Device (Angiojet) in Acute ST Elevation Myocardial Infarction with Large Amount of Coronary Thrombus
Thamarath Chantadansuwan MD*, Wirash Kehasukcharoen MD*, Kriengkrai Hengrussamee MD*
Affiliation : * Cardiology & Intervention Department, Central Chest Institute, Nonthaburi, Thailand
Background : Primary percutaneous coronary intervention (PCI) in acute ST elevation myocardial infarction (STEMI) is a
clinical challenge. Adequate thrombus removal before stenting is an important factor that predicts procedural success, and
finally reflects to clinical outcomes.
Cases Report: In the present report, 2 cases of acute STEMI underwent primary PCI. Coronary angiogram (CAG) in both
cases showed a large amount of coronary thrombus (TIMI thrombus grade 4 & grade 5), with no response to several
attempts of manual aspiration with thrombus aspiration catheter. Then, Angiojet rheolytic thrombectomy, a catheter-based,
device was used antegradely. Repeated CAG showed thrombus was significantly eliminated. Both patients were successfully
stented with direct stent technique at culprit arteries, resulted in good angiographic results and inhospital outcomes.
Conclusion : Angiojet, a rheolytic thrombectomy device, is a viable option to remove thrombus in primary PCI, especially in
cases with massive thrombus load and failed manual aspiration.
Keywords : Rheolytic thrombectomy device, Mechanical thrombectomy device, Angiojet, ST elevation myocardial infarction, Percutaneous coronary intervention
